Individual
MRS. LARISSA AZEVEDO DEPINA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
635 SUMMER ST, BROCKTON, MA 02302-4230
(508) 631-5532
Mailing address
635 SUMMER ST, BROCKTON, MA 02302-4230
(508) 631-5532
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
RN2267945
MA
Other
Enumeration date
03/06/2019
Last updated
03/06/2019
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